Mortality Risk amongst Nursing Home Residents Evacuated after the Fukushima Nuclear Accident: A Retrospective Cohort Study

Background

Safety of evacuation is of paramount importance in disaster planning for elderly people; however, little effort has been made to investigate evacuation-related mortality risks. After the Fukushima Daiichi Nuclear Plant accident we conducted a retrospective cohort survival survey of elderly evacuees.

Methods

A total of 715 residents admitted to five nursing homes in Minamisoma city, Fukushima Prefecture in the five years before 11th March 2011 joined this retrospective cohort study. Demographic and clinical characteristics were drawn from facility medical records. Evacuation histories were tracked until the end of 2011. The evacuation''s impact on mortality was assessed using mortality incidence density and hazard ratios in Cox proportional hazards regression.

Results

Overall relative mortality risk before and after the earthquake was 2.68 (95% CI: 2.04–3.49). There was a substantial variation in mortality risks across the facilities ranging from 0.77 (95% CI: 0.34–1.76) to 2.88 (95% CI: 1.74–4.76). No meaningful influence of evacuation distance on mortality was observed although the first evacuation from the original facility caused significantly higher mortality than subsequent evacuations, with a hazard ratio of 1.94 (95% CI: 1.07–3.49).

Conclusion

High mortality, due to initial evacuation, suggests that evacuation of the elderly was not the best life-saving strategy for the Fukushima nuclear disaster. Careful consideration of the relative risks of radiation exposure and the risks and benefits of evacuation is essential. Facility-specific disaster response strategies, including in-site relief and care, may have a strong influence on survival. Where evacuation is necessary, careful planning and coordination with other nursing homes, evacuation sites and government disaster agencies is essential to reduce the risk of mortality.     

Bipolarization of Risk Perception about the Health Effects of Radiation in Residents after the Accident at Fukushima Nuclear Power Plant

The late health effects of low-dose rate radiation exposure are still a serious public concern in the Fukushima area even four years after the accident at Fukushima Daiichi Nuclear Power Plant (FNPP). To clarify the factors associated with residents’ risk perception of radiation exposure and consequent health effects, we conducted a survey among residents of Kawauchi village in May and June 2014, which is located within 30 km of FNPP. 85 of 285 residents (29.8%) answered that acute radiation syndrome might develop in residents after the accident, 154 (54.0%) residents responded that they had anxieties about the health effects of radiation on children, and 140 (49.1%) residents indicated that they had anxieties about the health effects of radiation on offspring. Furthermore, 107 (37.5%) residents answered that they had concerns about health effects that would appear in the general population simply by living in an environment with a 0.23 μSv per hour ambient dose for one year, 149 (52.2%) residents reported that they were reluctant to eat locally produced foods, and 164 (57.5%) residents believed that adverse health effects would occur in the general population by eating 100 Bq per kg of mushrooms every day for one year. The present study shows that a marked bipolarization of the risk perception about the health effects of radiation among residents could have a major impact on social well-being after the accident at FNPP.     

Estimated Dietary Intake of Radionuclides and Health Risks for the Citizens of Fukushima City,Tokyo, and Osaka after the 2011 Nuclear Accident

The radionuclides released from the Fukushima Daiichi nuclear power plant in 2011 pose a health risk. In this study, we estimated the 1st-year average doses resulting from the intake of iodine 131 (¹³¹I) and cesium 134 and 137 (¹³⁴Cs and ¹³⁷Cs) in drinking water and food ingested by citizens of Fukushima City (∼50 km from the nuclear power plant; outside the evacuation zone), Tokyo (∼230 km), and Osaka (∼580 km) after the accident. For citizens in Fukushima City, we considered two scenarios: Case 1, citizens consumed vegetables bought from markets; Case 2, citizens consumed vegetables grown locally (conservative scenario). The estimated effective doses of ¹³⁴Cs and ¹³⁷Cs agreed well with those estimated through market basket and food-duplicate surveys. The average thyroid equivalent doses due to ingestion of ¹³¹I for adults were 840 µSv (Case 1) and 2700 µSv (Case 2) in Fukushima City, 370 µSv in Tokyo, and 16 µSv in Osaka. The average effective doses due to ¹³⁴Cs and ¹³⁷Cs were 19, 120, 6.1, and 1.9 µSv, respectively. The doses estimated in this study were much lower than values reported by the World Health Organization and the United Nations Scientific Committee on the Effects of Atomic Radiation, whose assessments lacked validation and full consideration of regional trade in foods, highlighting the importance of including regional trade. The 95th percentile effective doses were 2–3 times the average values. Lifetime attributable risks (LARs) of thyroid cancers due to ingestion were 2.3–39×10⁻⁶ (Case 1) and 10–98×10⁻⁶ (Case 2) in Fukushima City, 0.95–14×10⁻⁶ in Tokyo, and 0.11–1.3×10⁻⁶ in Osaka. The contributions of LARs of thyroid cancers due to ingestion were 7.5%–12% of all exposure (Case 1) and 12%–30% (Case 2) in Fukushima City.     

Neural Responses to Truth Telling and Risk Propensity under Asymmetric Information

Trust is multi-dimensional because it can be characterized by subjective trust, trust antecedent, and behavioral trust. Previous research has investigated functional brain responses to subjective trust (e.g., a judgment of trustworthiness) or behavioral trust (e.g., decisions to trust) in perfect information, where all relevant information is available to all participants. In contrast, we conducted a novel examination of the patterns of functional brain activity to a trust antecedent, specifically truth telling, in asymmetric information, where one individual has more information than others, with the effect of varying risk propensity. We used functional magnetic resonance imaging (fMRI) and recruited 13 adults, who played the Communication Game, where they served as the “Sender” and chose either truth telling (true advice) or lie telling (false advice) regarding the best payment allocation for their partner. Our behavioral results revealed that subjects with recreational high risk tended to choose true advice. Moreover, fMRI results yielded that the choices of true advice were associated with increased cortical activation in the anterior rostral medial and frontopolar prefrontal cortices, middle frontal cortex, temporoparietal junction, and precuneus. Furthermore, when we specifically evaluated a role of the bilateral amygdala as the region of interest (ROI), decreased amygdala response was associated with high risk propensity, regardless of truth telling or lying. In conclusion, our results have implications for how differential functions of the cortical areas may contribute to the neural processing of truth telling.     

Factors Associated with Nurses’ Intention to Leave Their Jobs after the Fukushima Daiichi Nuclear Power Plant Accident

We conducted a survey among nurses who were working at the Fukushima Medical University Hospital at the time of the Fukushima Daiichi Nuclear Power Plant accident to clarify the factors associated with their intention to leave their jobs during the radiation emergency. We asked 345 nurses (17 men and 328 women) about their intention to leave their jobs after the accident. We also asked about relevant factors including the participants’ demographic factors, living situation, working status, and knowledge of radiation health effects. We found that living with preschoolers (OR = 1.87, 95%CI: 1.02–3.44, p = 0.042), anxiety about life in Fukushima City after the accident (OR = 5.55, 95%CI: 1.18–26.13, p = 0.030), consideration of evacuation from Fukushima after the accident (OR = 2.42, 95%CI: 1.45–4.06, p = 0.001), consideration of the possible radiation health effects in children (OR = 1.90, 95%CI: 1.02–3.44, p = 0.042), and anxiety about relationships with colleagues in the hospital after the accident (OR = 3.23, p = 0.001) were independently associated with the nurses’ intention to leave their jobs after the accident. On the other hand, the percentage of nurses with knowledge on radiation health effects was relatively low among those who had the intention to leave the job and among those who did not have the intention to leave the job after the accident, with no significant differences between the two groups. Our results suggest the need for an education program for nurses regarding radiation health effects.     

The Thyroid Status of Children and Adolescents in Fukushima Prefecture Examined during 20–30 Months after the Fukushima Nuclear Power Plant Disaster: A Cross-Sectional,Observational Study

Background

A possible increase in thyroid cancer in the young represents the most critical health problem to be considered after the nuclear accident in Fukushima, Japan (March 2011), which is an important lesson from the Chernobyl disaster (April 1986). Although it was reported that childhood thyroid cancer had started to increase 3–5 yr after the Chernobyl accident, we speculate that the actual period of latency might have been shorter than reported, considering the delay in initiating thyroid surveillance in the then Soviet Union and also the lower quality of ultrasonographic testing in the 1980s. Our primary objectives in the present study were to identify any possible thyroid abnormality in young Fukushima citizens at a relatively early timepoint (20–30 months) after the accident, and also to strive to find a possible relationship among thyroid ultrasonographic findings, thyroid-relevant biochemical markers, and iodine-131 ground deposition in the locations of residence where they stayed during very early days after the accident.

Methods and Findings

This is a cross-sectional study. We targeted the Fukushima residents who were 18 yr old or younger (including fetuses) at the time of the accident. Our examinations comprised a questionnaire, thyroid ultrasonography, thyroid-related blood tests, and urinary iodine measurement. We analyzed a possible relationship among thyroid ultrasonographic findings (1,137 subjects), serum hormonal data (731 subjects), urinary iodine concentrations (770 subjects), and iodine-131 ground deposition (1,137 subjects). We did not find any significant relationship among these indicators, and no participant was diagnosed to contract thyroid cancer.

Conclusions

At the timepoint of 20–30 months after the accident, we did not confirm any discernible deleterious effects of the emitted radioactivity on the thyroid of young Fukushima residents. This is the first report in English detailing the thyroid status of young Fukushima residents after the nuclear disaster.     

Using “Big Data” to Capture Overall Health Status: Properties and Predictive Value of a Claims-Based Health Risk Score

BackgroundInvestigators across many fields often struggle with how best to capture an individual’s overall health status, with options including both subjective and objective measures. With the increasing availability of “big data,” researchers can now take advantage of novel metrics of health status. These predictive algorithms were initially developed to forecast and manage expenditures, yet they represent an underutilized tool that could contribute significantly to health research. In this paper, we describe the properties and possible applications of one such “health risk score,” the DxCG Intelligence tool.MethodsWe link claims and administrative datasets on a cohort of U.S. workers during the period 1996–2011 (N = 14,161). We examine the risk score’s association with incident diagnoses of five disease conditions, and we link employee data with the National Death Index to characterize its relationship with mortality. We review prior studies documenting the risk score’s association with other health and non-health outcomes, including healthcare utilization, early retirement, and occupational injury.

Results and Conclusions

We find that the risk score is associated with outcomes across a variety of health and non-health domains. These examples demonstrate the broad applicability of this tool in multiple fields of research and illustrate its utility as a measure of overall health status for epidemiologists and other health researchers.     

Tobacco Knowledge among Adults in Zhejiang Province,China

Objective

The aims of current study were to assess the level of tobacco knowledge, anti-tobacco messages and major information channels in Zhejiang.

Methods

Face-to-face interviews were conducted with 2112 adults in Zhejiang. Data on demographic information, smoking status, tobacco knowledge, anti-tobacco messages and major information channels was collected.

Results

The findings revealed that only 31.87% of the population were aware that smoking could cause all three diseases (stoke, heart disease, and lung cancer), 86.09% were aware that smoking causes lung cancer, 46.43% and 42.40% were aware that smoking causes stroke and heart attack, respectively. Residence and education level had significant effects on awareness, while the effects of smoking status, gender, age, and household monthly income were not significant. There were five major information channels as follows: television (67.52%), newspapers or magazines (40.79%), billboards (30.02%), public walls (24.72), and radio (23.79%). Respondents got the following anti-tobacco messages from mass media: “No smoking in public” (66.34%), “No smoking in front of other people” (35.18%) and “Not offering cigarettes to one another” (22.82%).

Conclusions

The tobacco knowledge among residents in Zhejiang province is relatively poor. Improved information channels and content of anti-tobacco messages are necessary to increase the public’s tobacco knowledge, particularly among rural residents and people with less education.     

Air Pollution from Industry and Traffic: Perceived Risk and Affect in the Moerdijk Region,The Netherlands

The aim of the present study was to compare the perceived risks of air pollution from industry and traffic in the Moerdijk region in The Netherlands, and to identify the demographic and psychometric variables that are associated with these perceived risks. We sent out a questionnaire and risk perceptions were explored using multiple regression models. The results showed that the perceived risks of industrial air pollution were higher than for those of traffic-related air pollution. The perceived risk of industrial air pollution was associated with other variables than that of traffic. For industry, the psychometric variable affect prevailed. For traffic-related air pollution, the demographic variables age and educational level prevailed, although affect was also apparent. Which source was considered as the major source—traffic or industry—depended on a high risk perception of industrial air pollution, and not on variation in risk perception of traffic-related air pollution. These insights can be used as an impetus for the local risk management process in the Moerdijk region. We recommend that local authorities consider risk perception as one of the targets in local risk management strategies as well.     

Relationship between Trusting Behaviors and Psychometrics Associated with Social Network and Depression among Young Generation: A Pilot Study

Maladaptive social interaction and its related psychopathology have been highlighted in psychiatry especially among younger generations. In Japan, novel expressive forms of psychiatric phenomena such as “modern-type depression” and “hikikomori” (a syndrome of severe social withdrawal lasting for at least six months) have been reported especially among young people. Economic games such as the trust game have been utilized to evaluate real-world interpersonal relationships as a novel candidate for psychiatric evaluations. To investigate the relationship between trusting behaviors and various psychometric scales, we conducted a trust game experiment with eighty-one Japanese university students as a pilot study. Participants made a risky financial decision about whether to trust each of 40 photographed partners. Participants then answered a set of questionnaires with seven scales including the Lubben Social Network Scale (LSNS)-6 and the Patient Health Questionnaire (PHQ)-9. Consistent with previous research, male participants trusted partners more than female participants. Regression analysis revealed that LSNS-family (perceived support from family) for male participants, and item 8 of PHQ-9 (subjective agitation and/or retardation) for female participants were associated with participants’ trusting behaviors. Consistent with claims by social scientists, our data suggest that, for males, support from family was negatively associated with cooperative behavior toward non-family members. Females with higher subjective agitation (and/or retardation) gave less money toward males and high attractive females, but not toward low attractive females in interpersonal relationships. We believe that our data indicate the possible impact of economic games in psychiatric research and clinical practice, and validation in clinical samples including modern-type depression and hikikomori should be investigated.     

Effects of News Frames on Perceived Risk,Emotions, and Learning

The media play a key role in forming opinions by influencing people´s understanding and perception of a topic. People gather information about topics of interest from the internet and print media, which employ various news frames to attract attention. One example of a common news frame is the human-interest frame, which emotionalizes and dramatizes information and often accentuates individual affectedness. Our study investigated effects of human-interest frames compared to a neutral-text condition with respect to perceived risk, emotions, and knowledge acquisition, and tested whether these effects can be "generalized" to common variants of the human-interest frame. Ninety-one participants read either one variant of the human-interest frame or a neutrally formulated version of a newspaper article describing the effects of invasive species in general and the Asian ladybug (an invasive species) in particular. The framing was achieved by varying the opening and concluding paragraphs (about invasive species), as well as the headline. The core text (about the Asian ladybug) was the same across all conditions. All outcome variables on framing effects referred to this common core text. We found that all versions of the human-interest frame increased perceived risk and the strength of negative emotions compared to the neutral text. Furthermore, participants in the human-interest frame condition displayed better (quantitative) learning outcomes but also biased knowledge, highlighting a potential dilemma: Human-interest frames may increase learning, but they also lead to a rather unbalanced view of the given topic on a “deeper level”.     

A Preconscious Neural Mechanism of Hypnotically Altered Colors: A Double Case Study

Hypnotic suggestions may change the perceived color of objects. Given that chromatic stimulus information is processed rapidly and automatically by the visual system, how can hypnotic suggestions affect perceived colors in a seemingly immediate fashion? We studied the mechanisms of such color alterations by measuring electroencephalography in two highly suggestible participants as they perceived briefly presented visual shapes under posthypnotic color alternation suggestions such as “all the squares are blue”. One participant consistently reported seeing the suggested colors. Her reports correlated with enhanced evoked upper beta-band activity (22 Hz) 70–120 ms after stimulus in response to the shapes mentioned in the suggestion. This effect was not observed in a control condition where the participants merely tried to simulate the effects of the suggestion on behavior. The second participant neither reported color alterations nor showed the evoked beta activity, although her subjective experience and event-related potentials were changed by the suggestions. The results indicate a preconscious mechanism that first compares early visual input with a memory representation of the suggestion and consequently triggers the color alteration process in response to the objects specified by the suggestion. Conscious color experience is not purely the result of bottom-up processing but it can be modulated, at least in some individuals, by top-down factors such as hypnotic suggestions.     

Facebook Use Predicts Declines in Subjective Well-Being in Young Adults

Over 500 million people interact daily with Facebook. Yet, whether Facebook use influences subjective well-being over time is unknown. We addressed this issue using experience-sampling, the most reliable method for measuring in-vivo behavior and psychological experience. We text-messaged people five times per day for two-weeks to examine how Facebook use influences the two components of subjective well-being: how people feel moment-to-moment and how satisfied they are with their lives. Our results indicate that Facebook use predicts negative shifts on both of these variables over time. The more people used Facebook at one time point, the worse they felt the next time we text-messaged them; the more they used Facebook over two-weeks, the more their life satisfaction levels declined over time. Interacting with other people “directly” did not predict these negative outcomes. They were also not moderated by the size of people''s Facebook networks, their perceived supportiveness, motivation for using Facebook, gender, loneliness, self-esteem, or depression. On the surface, Facebook provides an invaluable resource for fulfilling the basic human need for social connection. Rather than enhancing well-being, however, these findings suggest that Facebook may undermine it.     

Passive smoking and lung cancer: a publication bias?

To assess the likelihood of publication bias in a recent review of the effect of passive smoking on lung cancer the evidence from the reviewed papers was visualised on a “funnel” plot. In such a plot if the relative risks from various studies are plotted according to sample size they should scatter round some underlying true value, the scatter being greatest where the studies have the lowest statistical power—thus showing a “funnel” pattern. If there is publication bias and studies with non-significant results are not being published there should be a “gap” in the plot. The logarithm of the relative risks was plotted against the standard error of the logarithm of the relative risk (which was used instead of sample size as a measure of statistical uncertainty). The resulting plot was compatible with a publication bias but only in studies on men.Further studies of passive smoking and lung cancer in men seem to be warranted.     

Human Wagering Behavior Depends on Opponents' Faces

Research in competitive games has exclusively focused on how opponent models are developed through previous outcomes and how peoples'' decisions relate to normative predictions. Little is known about how rapid impressions of opponents operate and influence behavior in competitive economic situations, although such subjective impressions have been shown to influence cooperative decision-making. This study investigates whether an opponent''s face influences players'' wagering decisions in a zero-sum game with hidden information. Participants made risky choices in a simplified poker task while being presented opponents whose faces differentially correlated with subjective impressions of trust. Surprisingly, we find that threatening face information has little influence on wagering behavior, but faces relaying positive emotional characteristics impact peoples'' decisions. Thus, people took significantly longer and made more mistakes against emotionally positive opponents. Differences in reaction times and percent correct were greatest around the optimal decision boundary, indicating that face information is predominantly used when making decisions during medium-value gambles. Mistakes against emotionally positive opponents resulted from increased folding rates, suggesting that participants may have believed that these opponents were betting with hands of greater value than other opponents. According to these results, the best “poker face” for bluffing may not be a neutral face, but rather a face that contains emotional correlates of trustworthiness. Moreover, it suggests that rapid impressions of an opponent play an important role in competitive games, especially when people have little or no experience with an opponent.     

Economic Profits Enhance Trust,Perceived Integrity and Memory of Fairness in Interpersonal Judgment

Does money lead to trust in personality and intention of others? Humans have a strong tendency to judge the intention of others from their sequent behaviors. In general, people trust others who behave fairly, but not always. Here we show that judgments of both intentional aspects and memory of intentional behavior are automatically influenced by unintentional benefits from the behaviors of others. We conducted a reward-manipulated and repeated trust game by using real participants interacting with moving image partners on a computer screen. The participants assessed likability, trustworthiness, and perceived integrity of the partners in pre- and post-game questionnaires. The results of judgments of all three dimensions and the memory of frequency of each partner''s fair behavior (sharing) were strongly influenced by profitability in the trust game, even though all partners shared 75% of the profit and participants were told that profitability was randomly assigned to each partner. Furthermore, these effects were moderated by the gender of the participants: males were more sensitive to monetary profits than were females. The results reveal that humans automatically trust, approve the integrity of, and recall well the fair behavior of others who provide affectively positive outcomes such as monetary profits. We call this phenomenon the “affect ripple effect”.     

Perception of Affordance during Short-Term Exposure to Weightlessness in Parabolic Flight

We investigated the role of the visual eye-height (VEH) in the perception of affordance during short-term exposure to weightlessness. Sixteen participants were tested during parabolic flight (0g) and on the ground (1g). Participants looked at a laptop showing a room in which a doorway-like aperture was presented. They were asked to adjust the opening of the virtual doorway until it was perceived to be just wide enough to pass through (i.e., the critical aperture). We manipulated VEH by raising the level of the floor in the visual room by 25 cm. The results showed effects of VEH and of gravity on the perceived critical aperture. When VEH was reduced (i.e., when the floor was raised), the critical aperture diminished, suggesting that widths relative to the body were perceived to be larger. The critical aperture was also lower in 0g, for a given VEH, suggesting that participants perceived apertures to be wider or themselves to be smaller in weightlessness, as compared to normal gravity. However, weightlessness also had an effect on the subjective level of the eyes projected into the visual scene. Thus, setting the critical aperture as a fixed percentage of the subjective visual eye-height remains a viable hypothesis to explain how human observers judge visual scenes in terms of potential for action or “affordances”.     

The Caudate Signals Bad Reputation during Trust Decisions

The ability to initiate and sustain trust is critical to health and well-being. Willingness to trust is in part determined by the reputation of the putative trustee, gained via direct interactions or indirectly through word of mouth. Few studies have examined how the reputation of others is instantiated in the brain during trust decisions. Here we use an event-related functional MRI (fMRI) design to examine what neural signals correspond to experimentally manipulated reputations acquired in direct interactions during trust decisions. We hypothesized that the caudate (dorsal striatum) and putamen (ventral striatum) and amygdala would signal differential reputations during decision-making. Twenty-nine healthy adults underwent fMRI scanning while completing an iterated Trust Game as trusters with three fictive trustee partners who had different tendencies to reciprocate (i.e., likelihood of rewarding the truster), which were learned over multiple exchanges with real-time feedback. We show that the caudate (both left and right) signals reputation during trust decisions, such that caudate is more active to partners with two types of “bad” reputations, either indifferent partners (who reciprocate 50% of the time) or unfair partners (who reciprocate 25% of the time), than to those with “good” reputations (who reciprocate 75% of the time). Further, individual differences in caudate activity related to biases in trusting behavior in the most uncertain situation, i.e. when facing an indifferent partner. We also report on other areas that were activated by reputation at p < 0.05 whole brain corrected. Our findings suggest that the caudate is involved in signaling and integrating reputations gained through experience into trust decisions, demonstrating a neural basis for this key social process.     

Mammal assemblages recorded by camera traps inside and outside the evacuation zone of the Fukushima Daiichi Nuclear Power Plant accident

In 2011, the Fukushima Daiichi Power Plant accident resulted in the evacuation of about 81,000 people from the evacuation zone, which suffered from high levels of radioactive contamination. Large-scale and long-term land abandonment can cause changes in species assemblages. Despite the extensive global attention this incident received, open and spatially-explicit datasets of mammal fauna from Fukushima remain quite limited. We established a continuous monitoring protocol using camera traps for mammals both inside and outside the evacuation zone; this paper presents our first dataset. These data represent the monitoring results from 45 camera traps from May 2014 to October 2014, including the location and actuation time of each camera, and the list of video records. After the publication of this initial data paper, we intend to continue monitoring until 2023 and the dataset will be hereafter updated with new observations.     

Stress and the Multiple-Role Woman: Taking a Closer Look at the “Superwoman”

In the academic literature there is debate as to whether women who engage in multiple social roles experience more or less stress than women in fewer roles. For the present research we examined the relationship between levels of engagement in seven distinct roles and perceived stress and life satisfaction in a small non-random sample of women in North America (N = 308). We did not find a significant correlation between role engagement and perceived stress, though we did find a small but significant positive correlation between role engagement and life satisfaction. Similarly, in a subset of the participants (N = 31), there was not a significant relationship between the level of role engagement and physiological stress as measured by hair or urinary cortisol levels. We found a significant negative correlation between perceived stress and life satisfaction, and role satisfaction. The results from multiple regression models did not identify the level of role engagement as a significant predictor of either perceived stress or life satisfaction. Role satisfaction in addition to several life style variables such as the frequency of sex and exercise were identified as significant predictors of both outcome variables. We also examined the popularized notion of the “superwoman”, which we defined as women who fell within the 4^th quartile of role engagement, or those engaged in the wife/mother/worker/homemaker role combination. Based on popular discourses surrounding the superwoman we expected that superwomen would exhibit higher levels of perceived stress. Our results revealed that superwomen do not experience a significantly higher level of perceived stress than non-superwomen. The results of our study therefore suggest that multiple role engagement in women, even at a relatively high level as experienced by “superwomen”, is not associated with significantly higher stress, or reduced life satisfaction.